Shadetree Dermatology LLC

NPI #1366297376 in Cocoa Beach, Florida

Provider Information

NPI Number
1366297376
Entity Type
Organization
Organization Name
Shadetree Dermatology LLC
Primary Specialty
Dermatology
Enumeration Date
Apr 22, 2024
Last Updated
Aug 4, 2024

Practice Location

Address
105 S BANANA RIVER BLVD FL 2
State
Florida
ZIP Code
32931-5041
Phone
(321) 200-0346

Authorized Official

Name
DR. VANESSA EMILY JOHNSON, MD
Title
DERMATOLOGIST (PHYSICIAN)
Phone
(321) 200-0346

Specialties & Taxonomy Codes

Specialty
Dermatology

Additional Practice Locations

389 Commerce Pkwy Ste 160

Rockledge, FL, 32955-4202

(321) 200-0346

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